Posterior Circulation Stroke Secondary to Basilar Artery Thrombosis With a Fatal Outcome.

Stroke is a regularly encountered emergency by emergency physicians, categorized based on the culprit artery and diagnosed based on non-contrast computerized tomography (CT) brain, which is supported by clinical examination that can be treated intravenously by thrombolytic agents or mechanical thrombectomy. Here we present one such case, which was brought to the emergency room with symptoms of posterior circulation stroke within 8 hours and underwent mechanical thrombectomy.

Surprising Diagnosis of Myxedema Crisis In-Patient Who Presented With Altered Sensorium.

Hypothyroidism, a disorder of decreased thyroid hormone secretion diagnosed by increased thyroid stimulating hormone (TSH) and low free triiodothyronine (FT3) and free thyroxine (FT4) levels, is classified as primary and secondary hypothyroidism, depending on the pathology. Raised TSH levels are associated with primary hypothyroidism, while decreased levels of TSH are seen in secondary hypothyroidism. With the easy availability of diagnostic tests, hypothyroidism can be detected and managed early but can be life-threatening if not treated within time. Manifestations of hypothyroidism are dry skin, hoarseness of voice, weight gain, constipation, cold intolerance, fatigue, and lethargy; however, the clinical presentation can differ as per age and sex and person to person. Here, we present one such case, which was brought to the emergency room with a history of altered sensorium, hypotension, and swelling over the bilateral lower limbs and face, with a surprise diagnosis of myxedema crisis. The uniqueness of this case is the omnipresent availability of early diagnosis and treatment in this era. still got a female patient with altered sensorium who was diagnosed to be a myxedema crisis which was given a lesser thought in our provisional diagnosis.

A Sporadic Case of a 22-Year-Old Female With Spinal Cord Infarction (SCI) Complicated by SS Pattern Sickle Cell Disease (SCD): A Rare Case Report.

A stroke that occurs either in arteries that supply the spinal cord or the spinal cord itself is called spinal cord infarction (SCI). The lower thoracic area is the most typical site for spinal cord infarcts. Spinal infarcts are rare even among people without sickle cell disease, making up only a very less amount of all infarcts to the central nervous system. A 22-year-old female with a known case of SS pattern sickle cell anaemia was brought by her parents to the emergency medicine department with a complaint of pain in the bilateral upper and right lower limbs. The pain progressed to weakness within 15 minutes, which was sudden in onset and associated with faecal and urine incontinence. On physical examination of the client, her Glasgow coma scale (GCS) was E3 VT M5, pupils were bilateral and equally reactive to light, in both upper limbs, the power was 0/5 and 2/5 in the left lower limb, and hypotonia in the upper and right lower limb was noted. Still, the tone was expected in the left lower limb. MRI showed myelopathy extending over three segments from c2 to c4 involving predominantly anterior aspect, most likely cord ischemia. The patient was treated in the neurocritical care unit with tab Ecosprine 150 mg, multivitamins, and rehabilitative therapy. After two months, she showed gradual but consistent improvement in restoring some motor function in her affected limbs. SCIs are uncommon. Although ischemic stroke can be treated with anticoagulants and antiplatelet medicines, viable therapies for SCI have not yet been identified.

The Positive Impact of a Chemotherapeutic Approach on Relapse Ependymoma or WHO Grade III Anaplastic Ependymoma: Report of a Rare Case.

Children with recurrent ependymoma have a poor prognosis. Reirradiation has been proposed as an effective treatment for relapsed ependymoma. In this report, we present the case of a 14-year-old male child with a World Health Organization (WHO) grade III relapse ependymoma, emphasizing the imaging feature that helps differentiate the relapse ependymoma, which is a rarer condition in children. Being able to determine this tumor by its imaging appearance is important to risk stratify patient management decisions. The survival rate of ependymoma is usually five years, but in this case, we present a 14-year-old male child alive with reirradiation and chemotherapy management. The prognosis of the patient after undergoing treatment was good.